#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Validation of risk factors for recurrence of renal cell carcinoma: Results from a large single-institution series


Autoři: Johannes C. van der Mijn aff001;  Bashir Al Hussein Al Awamlh aff003;  Aleem Islam Khan aff003;  Lina Posada-Calderon aff003;  Clara Oromendia aff004;  Jonathan Fainberg aff003;  Mark Alshak aff003;  Rahmi Elahjji aff003;  Hudson Pierce aff003;  Benjamin Taylor aff003;  Lorraine J. Gudas aff001;  David M. Nanus aff005;  Ana M. Molina aff005;  Joseph Del Pizzo aff003;  Douglas S. Scherr aff003
Působiště autorů: Department of Pharmacology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, United States of America aff001;  Department of Medical Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands aff002;  Department of Urology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, United States of America aff003;  Department of Biostatistics and Epidemiology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, United States of America aff004;  Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, United States of America aff005
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0226285

Souhrn

Purpose

To validate prognostic factors and determine the impact of obesity, hypertension, smoking and diabetes mellitus (DM) on risk of recurrence after surgery in patients with localized renal cell carcinoma (RCC).

Materials and methods

We performed a retrospective cohort study among patients that underwent partial or radical nephrectomy at Weill Cornell Medicine for RCC and collected preoperative information on RCC risk factors, as well as pathological data. Cases were reviewed for radiographic evidence of RCC recurrence. A Cox proportional-hazards model was developed to determine the contribution of RCC risk factors to recurrence risk. Disease-free survival and overall survival were analyzed using the Kaplan-Meier method and log-rank test.

Results

We identified 873 patients who underwent surgery for RCC between the years 2000–2015. In total 115 patients (13.2%) experienced a disease recurrence after a median follow up of 4.9 years. In multivariate analysis, increasing pathological T-stage (HR 1.429, 95% CI 1.265–1.614) and Nuclear grade (HR 2.376, 95% CI 1.734–3.255) were independently associated with RCC recurrence. In patients with T1-2 tumors, DM was identified as an additional independent risk factor for RCC recurrence (HR 2.744, 95% CI 1.343–5.605). Patients with DM had a significantly shorter median disease-free survival (1.5 years versus 2.6 years, p = 0.004), as well as median overall survival (4.1 years, versus 5.8 years, p<0.001).

Conclusions

We validated high pathological T-stage and nuclear grade as independent risk factors for RCC recurrence following nephrectomy. DM is associated with an increased risk of recurrence among patients with early stage disease.

Klíčová slova:

Cancer risk factors – Histology – Hypertension – Obesity – Renal cell carcinoma – Surgical and invasive medical procedures – Surgical oncology


Zdroje

1. Patard JJ, Leray E, Rioux-Leclercq N, Cindolo L, Ficarra V, Zisman A, et al. Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol 2005 Apr 20;23(12):2763–2771. doi: 10.1200/JCO.2005.07.055 15837991

2. Hsieh JJ, Purdue MP, Signoretti S, Swanton C, Albiges L, Schmidinger M, et al. Renal cell carcinoma. Nat Rev Dis Primers 2017 Mar 9;3:17009. doi: 10.1038/nrdp.2017.9 28276433

3. Capitanio U, Bensalah K, Bex A, Boorjian SA, Bray F, Coleman J, et al. Epidemiology of Renal Cell Carcinoma. Eur Urol 2018 Sep 19.

4. Macleod LC, Hotaling JM, Wright JL, Davenport MT, Gore JL, Harper J, et al. Risk factors for renal cell carcinoma in the VITAL study. J Urol 2013 Nov;190(5):1657–1661. doi: 10.1016/j.juro.2013.04.130 23665301

5. Larsson SC, Wolk A. Diabetes mellitus and incidence of kidney cancer: a meta-analysis of cohort studies. Diabetologia 2011 May;54(5):1013–1018. doi: 10.1007/s00125-011-2051-6 21274512

6. Stewart SB, Thompson RH, Psutka SP, Cheville JC, Lohse CM, Boorjian SA, et al. Evaluation of the National Comprehensive Cancer Network and American Urological Association renal cell carcinoma surveillance guidelines. J Clin Oncol 2014 Dec 20;32(36):4059–4065. doi: 10.1200/JCO.2014.56.5416 25403213

7. Lam JS, Shvarts O, Leppert JT, Pantuck AJ, Figlin RA, Belldegrun AS. Postoperative surveillance protocol for patients with localized and locally advanced renal cell carcinoma based on a validated prognostic nomogram and risk group stratification system. J Urol 2005 Aug;174(2):466–72; discussion 472; quiz 801. doi: 10.1097/01.ju.0000165572.38887.da 16006866

8. Zisman A, Pantuck AJ, Wieder J, Chao DH, Dorey F, Said JW, et al. Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma. J Clin Oncol 2002 Dec 1;20(23):4559–4566. doi: 10.1200/JCO.2002.05.111 12454113

9. Karakiewicz PI, Briganti A, Chun FK, Trinh QD, Perrotte P, Ficarra V, et al. Multi-institutional validation of a new renal cancer-specific survival nomogram. J Clin Oncol 2007 Apr 10;25(11):1316–1322. doi: 10.1200/JCO.2006.06.1218 17416852

10. Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H. An outcome prediction model for patients with clear cell renal cell carcinoma treated with radical nephrectomy based on tumor stage, size, grade and necrosis: the SSIGN score. J Urol 2002 Dec;168(6):2395–2400. doi: 10.1097/01.ju.0000035885.91935.d5 12441925

11. Zigeuner R, Hutterer G, Chromecki T, Imamovic A, Kampel-Kettner K, Rehak P, et al. External validation of the Mayo Clinic stage, size, grade, and necrosis (SSIGN) score for clear-cell renal cell carcinoma in a single European centre applying routine pathology. Eur Urol 2010 Jan;57(1):102–109. doi: 10.1016/j.eururo.2008.11.033 19062157

12. Motzer RJ, Jonasch E, Agarwal N, Bhayani S, Bro WP, Chang SS, et al. Kidney Cancer, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2017 Jun;15(6):804–834.

13. Psutka SP, Stewart SB, Boorjian SA, Lohse CM, Tollefson MK, Cheville JC, et al. Diabetes mellitus is independently associated with an increased risk of mortality in patients with clear cell renal cell carcinoma. J Urol 2014 Dec;192(6):1620–1627. doi: 10.1016/j.juro.2014.06.014 24931804

14. Lee H, Kwak C, Kim HH, Byun SS, Lee SE, Hong SK. Diabetes Mellitus as an Independent Predictor of Survival of Patients Surgically Treated for Renal Cell Carcinoma: A Propensity Score Matching Study. J Urol 2015 Dec;194(6):1554–1560. doi: 10.1016/j.juro.2015.05.097 26066406

15. Parker AS, Cheville JC, Blute ML, Igel T, Lohse CM, Cerhan JR. Pathologic T1 clear cell renal cell carcinoma: insulin-like growth factor-I receptor expression and disease-specific survival. Cancer 2004 Jun 15;100(12):2577–2582. doi: 10.1002/cncr.20322 15197799

16. Hopkins BD, Pauli C, Du X, Wang DG, Li X, Wu D, et al. Suppression of insulin feedback enhances the efficacy of PI3K inhibitors. Nature 2018 Aug;560(7719):499–503. doi: 10.1038/s41586-018-0343-4 30051890

17. Courtney KD, Bezwada D, Mashimo T, Pichumani K, Vemireddy V, Funk AM, et al. Isotope Tracing of Human Clear Cell Renal Cell Carcinomas Demonstrates Suppressed Glucose Oxidation In Vivo. Cell Metab 2018 Nov 6;28(5):793–800.e2. doi: 10.1016/j.cmet.2018.07.020 30146487

18. Morgan TM, Mehra R, Tiemeny P, Wolf JS, Wu S, Sangale Z, et al. A Multigene Signature Based on Cell Cycle Proliferation Improves Prediction of Mortality Within 5 Yr of Radical Nephrectomy for Renal Cell Carcinoma. Eur Urol 2018 May;73(5):763–769. doi: 10.1016/j.eururo.2017.12.002 29249291

19. Brooks SA, Brannon AR, Parker JS, Fisher JC, Sen O, Kattan MW, et al. ClearCode34: A prognostic risk predictor for localized clear cell renal cell carcinoma. Eur Urol 2014 Jul;66(1):77–84. doi: 10.1016/j.eururo.2014.02.035 24613583

20. Cancer Genome Atlas Research Network. Comprehensive molecular characterization of clear cell renal cell carcinoma. Nature 2013 Jul 4;499(7456):43–49. doi: 10.1038/nature12222 23792563

21. Ueno D, Xie Z, Boeke M, Syed J, Nguyen KA, McGillivray P, et al. Genomic Heterogeneity and the Small Renal Mass. Clin Cancer Res 2018 Sep 1;24(17):4137–4144. doi: 10.1158/1078-0432.CCR-18-0214 29760223

22. Turajlic S, Xu H, Litchfield K, Rowan A, Chambers T, Lopez JI, et al. Tracking Cancer Evolution Reveals Constrained Routes to Metastases: TRACERx Renal. Cell 2018 Apr 19;173(3):581–594.e12. doi: 10.1016/j.cell.2018.03.057 29656895


Článek vyšel v časopise

PLOS One


2019 Číslo 12
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

KOST
Koncepce osteologické péče pro gynekology a praktické lékaře
nový kurz
Autoři: MUDr. František Šenk

Sekvenční léčba schizofrenie
Autoři: MUDr. Jana Hořínková

Hypertenze a hypercholesterolémie – synergický efekt léčby
Autoři: prof. MUDr. Hana Rosolová, DrSc.

Svět praktické medicíny 5/2023 (znalostní test z časopisu)

Imunopatologie? … a co my s tím???
Autoři: doc. MUDr. Helena Lahoda Brodská, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#